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Vancomycin-Resistant Enterococcus

About the organism

Vancomycin resistant enterococci are specific types of antimicrobial-resistant bacteria that are resistant to vancomycin. Enterococci are bacteria that are normally present in the intestinal tract of all people and in the female genital tract. It is also often found in the environment.

VRE can sometimes cause infections in the urinary tract, the bloodstream, or in wounds associated with catheters or surgical procedures. The following persons are at an increased risk of becoming infected with VRE:

People who have been previously treated with vancomycin or other antibiotics for long periods of time

People who are hospitalized, particularly when they receive antibiotic treatment for long periods of time

People with weakened immune systems such as patients in intensive care units or in cancer or transplant wards

People who have undergone abdominal or chest surgeries

People with medical devices that stay in for some time, such as urinary catheters or central intravenous catheters

People who have clostridium difficile diarrhea

People who are colonized with VRE

VRE is often passed from person to person by the contaminated hands of caregivers. VRE can get onto a caregiver's hands after they have contact with other people with VRE or after contact with contaminated surfaces. VRE can also be spread directly to people after they touch surfaces that are contaminated with VRE. VRE is not spread through the air by coughing or sneezing.

Infection prevention and control

If you see the EPIC VRE FYI alert screen in a patient's chart, please make sure the patient is oncontact precautions. Clinicians should notify the Department of Infection Prevention and Control if a patient with VRE or a history of VRE is identified but no FYI alert appears in EPIC

VRE is a hearty organism capable of surviving on environmental surfaces for extended periods of time and can easily move from inanimate objects to the hands of healthcare workers or support staff and then possibly to the patients. Therefore it is important that healthcare workers maintain a clean environment and good hand hygiene practices. Be sure to wash your hands and place all inpatients that have a history of VRE (or a positive VRE culture) in contact precautions. contact precautions for VRE means:

Placing patient in a private room (or in a room with another VRE patient)